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A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of SCH 530348 in Addition to Standard of Care in Subjects With Acute Coronary Syndrome: Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRA•CER) - TRA•CER

Conditions
Acute Coronary Syndrome
MedDRA version: 9.1Level: LLTClassification code 10051592Term: Acute coronary syndrome
Registration Number
EUCTR2006-002809-31-AT
Lead Sponsor
Schering Plough Research Institute, a Division of Schering Corporation
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
12500
Inclusion Criteria

The subject must meet ALL the criteria listed below for entry:
1. Subject must be 18 years of age or older, and may be of either sex and of any race
2. Subject must have a current clinical manifestation of NSTEACS according to the following 3 criteria:
a. history of cardiac-ischemia-related symptoms of at least 10 minutes duration =24 hours prior to hospital presentation
AND
b. any one (or more) of the following 2 criteria:
i. concurrent biomarker evidence - elevated troponin I or troponin T greater than the stated upper limit of normal (ULN) at the study site, OR creatine kinase-myocardial band (CK-MB) greater than the ULN at the study site
ii. concurrent electrocardiographic evidence – electrocardiogram (ECG) changes comprising new or presumably new ST-segment depression =0.1 mV (= 1 mm), or transient (<30 minutes) ST-segment elevation =0.1 mV (= 1 mm) in at least two contiguous leads
AND
c. any one (or more) of the following 4 criteria:
i. age = 55 years (Note: Subjects 55 to 59 years will be enrolled so long as the overall occurrence of blinded suspected endpoint events in this age group remains at least a minimum acceptable level as determined by the Executive Committee. Should the occurrence in this age group decrease below a minimum acceptable level as determined by the Executive Committee, the committee may recommend to the sponsor that this age category be removed as a sufficient third criterion for eligibility. Should the sponsor accept the recommendation, investigators would be notified that, moving forward, only age = 60 years would be a sufficient third criterion for eligibility).
ii. documented prior history of MI or coronary revascularization (PCI or CABG)
iii. diabetes [documented use of insulin or oral hypoglycemic(s)]
iv. peripheral arterial disease as indicated by a history of intermittent claudication and either
a. a resting ankle/brachial index of<0.85, or
b. amputation, peripheral bypass, or peripheral angioplasty of the extremities
secondary to ischemia
3. Subject must be willing and able to give informed consent
4. A woman of child-bearing potential who is currently sexually active must agree to use a medically accepted method of contraception prior to screening, while receiving protocol-specified medication, and for 2 months after stopping the medication. Highly effective methods of birth control are defined as those that result in a low failure rate (ie, <1% per year) when used consistently and correctly, such as hormonal implants, injectables, combined oral contraceptives, hormonal intrauterine devices, sexual abstinence, or surgical sterilization (eg, vasectomy of male partner).
5. A woman of child-bearing potential who is not currently sexually active must agree to use a medically accepted method of contraception should she become sexually active while participating in the study
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

The subject will be excluded from entry if ANY of the criteria listed below are met:
1. Concurrent or anticipated treatment with warfarin (or derivatives, eg, phenprocoumon), oral factor Xa inhibitor, or oral direct thrombin inhibitor after enrollment. (Note 1: If a subject is taking warfarin during determination of eligibility and the investigator is willing to stop the subject’s treatment with warfarin immediately, and the subject is not otherwise disqualified from participation, then the subject may receive randomized assignment of the study drug). (Note 2: A subject who was not using warfarin/derivatives and for whom use was not anticipated, but who subsequently requires warfarin/derivatives after randomized assignment of study drug may continue treatment with warfarin/derivatives and randomized study drug, except when aspirin/thienopyridine/warfarin concurrent therapy is needed and thienopyridine cannot be discontinued).
2. Concurrent or anticipated treatment with a potent inducer (eg, rifampin) or potent inhibitor (eg, ketoconazole, erythromycin) of CYP3A4 isoenzymes (detailed list will be supplied to investigator). (Note: A subject who was not using a potent CYP 3A4 inducer or potent inhibitor and/or for whom such therapy was not anticipated, but who subsequently requires such therapy after randomization may receive such therapy as follows:
a. potent 3A4 inducer – continue study drug until therapy with inducer ends or until
inducer therapy extends beyond 4 weeks, then discontinue study drug.
b. potent 3A4 inhibitor – interrupt study drug until inhibitor therapy ends or until
inhibitor therapy extends beyond 4 weeks, then discontinue study drug).
3. History of a bleeding diathesis, or evidence of active abnormal bleeding within 30 days before enrollment
4. History at any time of intracranial hemorrhage,(except microhemorrhage”) intracranial or spinal cord surgery, or a central nervous system tumor or aneurysm
5. Documented sustained severe hypertension (systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg) at enrollment or within the previous 10 days
6. Severe valvular heart disease, as defined by the American College of Cardiology/American Heart Association
7. History within 2 weeks prior to enrollment of major surgery other than mentioned above or of ischemic (presumed thrombotic) stroke
8. known history of thrombocytopenia (conventionally defined as platelet count <100,000/mm3) occurring within 30 days before enrollment
9. Known hepatobiliary disease, or known unexplained persistent increase in serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) activity to two times or more the upper limit of the reference range (upper limit of normal [=2xULN]) within 30 days before enrollment
10. Any serious illness or any condition that the investigator feels would (a) pose a significant hazard to the subject if investigational therapy were initiated, or (b) would limit the prognosis of the subject, regardless of investigational therapy
11. Any serious medical comorbidity (eg, active malignancy) such that the subject's life expectancy is < 24 months
12. Previous participation in the current study
13. Current participation in any other study of investigational therapy, or participation in such a study within the last 30 days
14. Known hypersensitivity to any component of the current investigational product
15. Subject is a woman who is breast-feeding, pregnant or who intends to

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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